Hippokratia 2000, 4(2):90-93
N. Sikas, A. Asderakis, H. Riad
Loin pain-hematuria syndro-me is a rare disease, of unknown etiology, characterized by severe loin pain, persistent hematuria and normal kidney function. In this study 2 cases are reported and the diagnostic and therapeutic approach are analyzed.Two patients (1 female and 1 male, aged 38 and 32 years respectively) presented with progressively deteriorating loin pain (bilaterally the 1st patient and on the left side the second one) and hematuria for 4 and 6 years respectively.
During this period of time they underwent detailed radiological investigations including intravenous pyelography, CT scan and renal angiogram as well as renal biopsy and full immunological, hematology and biochemistry tests. All these tests were found to be normal and for the pain control they were on non-steroidal anti-inflammatory drugs and high doses of opioids. Both of them underwent autotransplantation, bilateral the 1st patient and on the left the 2nd patient.
The 1st patient developed recurrent symptoms on the right side 14 years after autotransplantation. This was initially managed with sympathectomy and 3 years later she required nephrectomy because of persistent symptoms. The 2nd patient, 12 months after his autotransplantation remains asymptomatic and takes no analgesia.Autotransplantation is the only way of managing the symptoms of this syndrome. In case of recurrence, nephrectomy is considered absolutely necessary.